II. Definitions

  1. Proptosis (Exophthalmos)
    1. Forward displacement, protruding or bulging of globe

III. Causes: Duration

  1. Acute Onset
    1. Orbital disease
    2. Cavernous Sinus Disease
  2. Chronic Onset
    1. Graves Disease (autoimmune Thyroiditis)
    2. Orbital Mass lesion!

IV. Causes: Symmetry

  1. Bilateral Proptosis
    1. Graves Disease (autoimmune Thyroiditis)
  2. Unilateral Proptosis
    1. Orbital Tumor or Neoplasm
    2. Orbital pseudotumor (autoimmune eye inflammation)
      1. Presents with lid inflammation, Eye Pain and ophthlmoplegia (eye Muscle paralysis)
    3. Cavernous Sinus Thrombosis
      1. Present with ill appearance with Headache, Vomiting, Vision change and Altered Level of Consciousness
    4. Endophthalmitis

V. Signs

  1. Stand behind seated patient and look down
    1. Compare positions of both Corneas
  2. Viewing from front
    1. Ring of white Sclera seen between iris and lids

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